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Titolo:
Applicability of diagnostic recommendations on dementia in family practice
Autore:
van Hout, H; Vernooij-Dassen, M; Poels, P; Hoefnagels, W; Grol, R;
Indirizzi:
Free Univ Amsterdam, Dept Gen Practice, EMGO Inst, NL-1081 BT Amsterdam, Netherlands Free Univ Amsterdam Amsterdam Netherlands NL-1081 BT terdam, Netherlands Univ Nijmegen, Ctr Qual Care Res, Nijmegen, Netherlands Univ Nijmegen Nijmegen Netherlands Qual Care Res, Nijmegen, Netherlands Univ Med Ctr, Dept Geriatr Med, St Radboud, Netherlands Univ Med Ctr St Radboud Netherlands eriatr Med, St Radboud, Netherlands
Titolo Testata:
INTERNATIONAL JOURNAL FOR QUALITY IN HEALTH CARE
fascicolo: 2, volume: 13, anno: 2001,
pagine: 127 - 133
SICI:
1353-4505(200104)13:2<127:AODROD>2.0.ZU;2-0
Fonte:
ISI
Lingua:
ENG
Soggetto:
RANDOMIZED CONTROLLED TRIAL; GENERAL-PRACTITIONERS; ELDERLY PATIENTS; PRIMARY-CARE; CLINICAL GUIDELINES; ALZHEIMERS-DISEASE; COGNITIVE IMPAIRMENT; DEPRESSION; INTERVENTIONS; MANAGEMENT;
Keywords:
applicability; dementia; family practitioner; guideline; recommendations;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Social & Behavioral Sciences
Citazioni:
44
Recensione:
Indirizzi per estratti:
Indirizzo: van Hout, H Free Univ Amsterdam, Dept Gen Practice, EMGO Inst, Van der Boechorstr 7, NL-1081 BT Amsterdam, Netherlands Free Univ Amsterdam Van der Boechorstr 7 Amsterdam Netherlands NL-1081 BT
Citazione:
H. van Hout et al., "Applicability of diagnostic recommendations on dementia in family practice", INT J QUAL, 13(2), 2001, pp. 127-133

Abstract

Objective. To evaluate the applicability of the Dutch dementia guideline'srecommendations, including the diagnostic criteria used by family practitioners, and to explore characteristics in both patients and family practitioners which are associated with the use of these recommendations. Design. An observational study was set up with a sample of 64 family practitioners who were instructed to use the Dutch national dementia guideline on incident-suspected dementia patients. The applicability was expressed as the percentage of recommendations applied. The use of diagnostic criteria was checked by comparing the family practitioners diagnoses with the diagnoses received by integrating the registered symptoms according to the DSM-III-R criteria. Associations between the number of recommendations applied, and demographic and clinical features were explored. Main outcome measures. (i) guideline applicability (ii) integrated use of DSM-III-R criteria. Results. 207 patients were included. The average application rate of the guideline's 31 diagnostic key recommendations was 86% or 24.8 (SD 3.6). The family practitioners diagnoses were consistent with the expected DSM-III-R diagnoses in 26% of the cases (kappa =0.1). A greater number of patients ina practice was positively associated with the use of recommendations. A need for referral by the family practitioners, and patients' denial of dementia were negatively associated with the use of recommendations. The presenceof dementia and a patient's age were negatively associated with the use ofthe DSM-III-R criteria. Conclusions. The applicability of the diagnostic recommendations of the national Dutch dementia guideline in a representative sample of family practitioners was promising. Nevertheless, the diagnostic criteria of the DSM-III-R, which were pan of the dementia guideline, provided little or no guidance to the family practitioners in their diagnostic decision-making. Clinicaland demographic variables explained some of the variation in the use of recommendations.

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Documento generato il 19/01/20 alle ore 20:27:53